Mental health funding battle looms after Newtown

Billie Davidson came to Daytona Beach looking for sobriety and a new start. Instead, 59-year-old Davidson found herself living in the shadows — broke and depressed.

SKYLER SWISHERSTAFF WRITER

DAYTONA BEACH — Billie Davidson came to Daytona Beach looking for sobriety and a new start. Instead, 59-year-old Davidson found herself living in the shadows — broke and depressed. For nearly a year, a green 1997 Dodge Caravan was all she had to her name. She slept in unlit areas to avoid detection and worried constantly about violating trespassing and vagrancy laws. "Many people didn't know I was homeless," Davidson said. "When they found out, they would take a step back — like I had something catching." She is one of thousands of Floridians who suffer from mental illness. She's not prone to violence. She looks like anyone's grandmom. The Newtown, Conn., shootings at Sandy Hook Elementary School directed the nation's attention toward the funding of mental health services. Although mass shooters might suffer from mental disorders, research studies have shown the mentally ill are more likely to be victims of violence than the perpetuators. With tax revenues on the rise for the first time in years and a renewed focus on mental health issues spurred by tragic shootings, now is the time to make a push for more funding, mental health advocates say. And it's people like Davidson who could be the beneficiaries.

'OVERSTRETCHED SYSTEM'

Lawmakers have an opportunity to make dramatic improvements in the state's mental health system and offset an (inflation-adjusted) reduction in funding since the 1960s, said Bob Sharpe, president and CEO of the Florida Council for Community Mental Health. Sharpe said the state has been left with an "under-resourced, overstretched system." Florida spends $39 per person on mental health services, ranking 49th among the 50 states and the District of Columbia, according to the Kaiser Family Foundation, a nonprofit, nonpartisan group that provides analysis on health issues. Only Idaho and Texas spend less. "It's really a tragic situation for the people with mental illness and their families," said Sharpe, whose organization represents 70 community-based mental health and substance abuse agencies. "There are large numbers of Floridians either directly or indirectly affected. Most people know someone in their own family who has a mental illness." As a result of funding reductions, long wait times often exist to access services, residential treatment facilities are limited and, in some cases, providers ration care to serve only the most severely mentally ill, Sharpe said. In Volusia and Flagler, the wait time for mental health services at Stewart-Marchman-Act Behavioral Healthcare is three months, said Chet Bell, the agency's CEO. Crisis intervention can be provided sooner for extreme cases, but the rationing of care is not ideal, he said. Inpatient care can be even harder to come by. Funding reductions forced Stewart-Marchman-Act to close a 12-bed short-term residential treatment unit, Bell said.

MORE THAN NUMBERS

Behind the numbers are people — many of whom have coped with mental illness their entire lives. About a quarter of U.S. adults suffer from some kind of mental disorder, according to the National Institute of Mental Health. Davidson grew up drinking beer on her dad's knee. When Davidson was 10, her sister died, an experience that had a profound effect on her. For much of her life, Davidson drank and abused prescription medication to mask the pain of her depression. A native of Palm Beach County, she moved to Daytona Beach in 1989 and raised two daughters by herself, working in hotels, restaurants and a variety of other service jobs. Four years ago, she moved to southeast Georgia to be close to another ailing sister. When she died, Davidson returned to Daytona in November 2011 but found it to be much different. Storefronts were shuttered, and the bountiful job postings she remembered were limited. "When I came back here, I was appalled," Davidson said. "There were no jobs. People were just desperate." She stopped drinking — not wanting to be known as the drunken grandmother stumbling around in a stupor. Unable to find stable work, she gave rides to the homeless and others for money. She feared what she might encounter on the streets. "Every night before I slept I'd say, 'God protect me and keep me safe,' " she recalled. She also witnessed acts of kindness on the streets of Daytona Beach. She remembered seeing a former certified nursing assistant who had fallen on hard times washing homeless people in wheelchairs in a public restroom. Looking for help, she visited the Star Family Center, a homeless shelter on North Street in Daytona Beach, to shower and eat. That's where she learned of a program called Projects in Assistance in Transition from Homelessness (PATH). Offered by the nonprofit Haven Recovery Center, the program provides counseling and other services to people without homes suffering from mental illness and substance abuse problems. Davidson arrived in tears, saying she was too old to be homeless. She was deeply depressed, withdrawn and couldn't focus, said Betty Butler, a North Street clinic case manager. Through a program offered by Stewart-Marchman-Act, she was able to get back on her depression medication. She received the support of a counselor. Her outlook changed. For many participants in the program, it's the first time they've ever been diagnosed with a mental health issue. Fifty-two-year-old Antonio Hester, who spent four years on the streets, didn't get help for bipolar disorder until he was well into middle age and entered the PATH program. Now, he said he's on medication, and his mood is stabilized. Before, he turned to crack and alcohol to cope, but he said he's making progress staying sober because of the help he received.

FUNDING ISSUES

Gov. Rick Scott's budget proposal holds mental health funding steady, despite a call from Sharpe's organization to restore $24 million in funding lost last year and increase spending by $75 million. The governor's spending plan calls for $4 billion in increases in other areas, including $1.2 billion in additional spending on K-12 education. Funding mental health is important for Scott, which is why he maintained existing funding levels instead of cutting services, Jackie Schultz, a Scott spokeswoman, wrote in an email. She didn't respond to follow-up questions asking whether Scott views the system as being underfunded and whether he would support Sharpe's proposal for $75 million in new funding. State Sen. John Thrasher, R-St. Augustine, said he's open to providing more funding for mental health, but state lawmakers must avoid spending recklessly. The state has to balance many different priorities from education to transportation, while keeping a healthy reserve in case of an emergency. "There's a need to be prudent about how we utilize taxpayer dollars," Thrasher said. "We are one hurricane away from a disaster in our state." Mental health advocates want more money to train teachers, police officers and first responders on mental health first aid, Sharpe said. The training sessions would teach them how to recognize and respond to mental illness. The dollars also would be directed toward expanding school-based mental health programs for students, helping community mental health providers shorten wait times and re-establishing residential programs, Sharpe said. In addition to new mental health funding, advocates are supporting efforts to expand Medicaid, a federal-state program that helps pay for health care for the needy, including mental health treatment. If expanded, as many as 1 million Floridians would gain coverage, giving them access to services and freeing up dollars mental health agencies spend treating the uninsured. Under health care reform, the federal government would pick up 100 percent of the cost from 2014 to 2016. Funding would diminish until it reaches 90 percent in 2022. Scott did not take a position on the Medicaid expansion in his budget plan. If Medicaid were expanded, Stewart-Marchman-Act would see the percentage of insured patients it sees jump from about 30 percent to 90 percent, Bell said.

COMING HOME

After months of waiting, Davidson learned she would finally get a place to call home. She landed a slot in Haven Recovery Center's My Place Apartments. The 16-unit apartment building — across the street from the Star Family Center — offers housing to 24 homeless people with persistent substance abuse and mental health issues. Davidson shares an apartment with another formerly homeless woman her age. She moved in Dec. 21. For Butler, Davidson is a success story. Far too often, the mentally ill want help, but they fall through the cracks, she said. When Davidson moved into her apartment, she sold the green van she lived in for nearly a year. She relies on public transportation. She doesn't miss the Caravan. She has a permanent place to stay now. "I love the sound of that word — permanent," Davidson said.